Nature mental health最新文献

{"title":"Algorithmically driven exposure to online self-harm content and its association with broader psychosocial risk in 32,000 adolescents","authors":"Holly Bear, Emma Soneson, Galit Geulayov, Mina Fazel","doi":"10.1038/s44220-026-00682-w","DOIUrl":"10.1038/s44220-026-00682-w","url":null,"abstract":"Adolescents increasingly inhabit digital environments where exposure to self-harm content may occur unintentionally or through active engagement, yet little is known about how different exposure pathways relate to psychosocial risk. Here we examine past-month exposure to online self-harm content, its frequency and pathways of exposure using 2025 OxWell Student Survey data from 32,102 students aged 11–18 years in England. One-third of students (34.5%) reported past-month exposure, predominantly unintentional (passive) and most commonly through algorithmic feed suggestions (66.2% of exposed students). Exposure occurred across five distinct pathways, each associated with elevated psychosocial risk as characterized by higher loneliness, greater experience of online harms and poorer mental health. Students exposed through intentional (active) or mixed exposure pathways had particularly pronounced risk profiles. These findings highlight the high proportion of adolescents currently exposed to online self-harm content, most often unintentionally encountered through algorithm-driven social media feeds. Reducing harm will require a multipronged public health response to limit widespread passive exposure driven by platform algorithms, alongside tailored approaches to identify and support the smaller but more vulnerable group of adolescents more actively engaging with this content. Coordinated action spanning adolescent digital literacy, platform design, regulation and enforcement is essential. Bear et al. examine the prevalence, frequency and pathways of adolescents’ exposure to online self-harm content using 2025 OxWell Student Survey data from 32,102 students aged 11–18 years in England.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"4 9","pages":"1416-1425"},"PeriodicalIF":9.3,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s44220-026-00682-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global mental health benefits from expanding microbiome–gut–brain axis research to the global south","authors":"Benjamin Valderrama, Livia H. Morais, Aonghus Lavelle, Sian M. J. Hemmings, Lindsay J. Hall, Zul Merali, Gerard Clarke, John F. Cryan","doi":"10.1038/s44220-026-00690-w","DOIUrl":"10.1038/s44220-026-00690-w","url":null,"abstract":"The microbiome–gut–brain axis is shaped by environmental factors, and increasing evidence suggests that the axis sustains brain health. However, most research is conducted in high-income countries (HICs). Although calls to expand this research into low- and middle-income countries (LMICs) are often grounded in solidarity constructs, they overlook an equally crucial aspect: studying the axis in LMICs offers an innovative route to derive concrete mental health benefits globally. Here we provide three arguments to justify why expanding the geographic boundaries of microbiome–gut–brain axis research supports global relevance and warn about the consequences of failing to do so. The overrepresentation of HICs may (1) lead to distortion of our understanding of the role of the microbiome–gut–brain axis in mental health; (2) lead us to miss a unique opportunity to disentangle complex environmental forces through studying ‘natural experiments’ occurring in LMICs, and (3) limit the development of global mental health interventions derived from lifestyles in LMICs. We thus argue that expanding microbiome–gut–brain axis research in LMICs is not just ethically desirable; it is a duty of scientific rigor with potential to yield global mental health benefits. This Perspective emphasizes the necessity of expanding microbiome–gut–brain axis studies into low- and middle-income countries, highlighting potential insights into mental health and environmental interactions, while addressing ethical responsibilities and the need for diverse global health interventions.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"4 8","pages":"1207-1215"},"PeriodicalIF":9.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148696731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide impact of heat on suicide and homicide in Mexico and Brazil","authors":"Hao-Neng Huang, Tao Pan, Alexandre Dias Porto Chiavegatto Filho, Jun Yang, Jia-Yang Wang, Chun-Quan Ou, Zhou Yang","doi":"10.1038/s44220-026-00684-8","DOIUrl":"10.1038/s44220-026-00684-8","url":null,"abstract":"Understanding how temperature, an environmental factor associated with suicide and homicide, may assist in identifying preventive approaches at the population level. However, significant gaps remain in understanding this association in tropical developing regions with high homicide and suicide burdens, where underlying socio-structural factors may critically modify temperature effects. By integrating 1,243,596 records extracted from two national mortality information systems and daily weather data between 2000 and 2019, the relationship between increased ambient mean temperature and the risk of suicide and homicide mortality was investigated using a time-stratified case-crossover design. Odds ratios and 95% confidence intervals (CIs) of temperature-associated mortality were estimated using the conditional logistic regression model combined with the distributed lag nonlinear model. Pooled estimates suggested each 1 °C increase in ambient mean temperature was associated with a 2.17% (95% CI 1.72–2.63%) and 1.80% (95% CI 1.33–2.27%) increase in homicide over lag 0–5 days in Brazil and Mexico, and the estimates for suicide were 2.78% (95% CI 2.18–3. 39%) and 3.75% (95% CI 3.05–4.46%), respectively. The association appeared stronger among males, mixed-race individuals in Brazil, during weekends, and in summer–autumn. Socioeconomic factors significantly modified the association between temperature and risks of suicide and homicide mortality. Throughout the study period, 10.19% of suicides and 9.43% of homicides in Brazil, along with 12.97% of suicides and 12.56% of homicides in Mexico, were associated with temperatures exceeding state-specific medians. Our findings emphasize the significance of heat adaptation strategies throughout almost the year to mitigate self-harm and interpersonal violence. In this study, Huang et al. link rising ambient temperatures to increased suicide and homicide mortality in Brazil and Mexico, showing stronger effects in specific groups and contexts and highlighting the role of socioeconomic factors and the need for heat adaptation strategies.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"4 8","pages":"1297-1306"},"PeriodicalIF":9.3,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148696678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and cost-effectiveness of digital approaches for training frontline health workers in depression care: a randomized controlled trial","authors":"John A. Naslund, Deepak Tugnawat, Aditya Anand, Zafra Cooper, Sona Dimidjian, Christopher G. Fairburn, Bethany Hedt-Gauthier, Steven D. Hollon, Udita Joshi, Azaz Khan, Chunling Lu, Lauren M. Mitchell, Shital Muke, Abhijit Nadkarni, Carina Akemi Nakamura, Rohit Ramaswamy, Juliana L. Restivo Haney, Ritu Shrivastava, Abhishek Singh, Daisy R. Singla, G. Sai Teja, Anant Bhan, Vikram Patel","doi":"10.1038/s44220-026-00693-7","DOIUrl":"10.1038/s44220-026-00693-7","url":null,"abstract":"Task-sharing psychosocial interventions to frontline health workers can expand access to mental health care. However, training remains a major barrier to scale. Here, in this randomized controlled trial, we evaluated the effectiveness and cost-effectiveness of two digital training approaches compared with classroom-based training for improving knowledge to deliver behavioral activation for depression. Accredited Social Health Activists in rural Madhya Pradesh, India, were randomized to self-directed digital training (DGT), digital training plus remote coaching (DGT+) or face-to-face classroom-based training (F2F). The primary outcome was change in knowledge scores from before training to after training. Among 339 Accredited Social Health Activists enrolled, completion rates were 87% (DGT), 96% (DGT+) and 92% (F2F). Knowledge scores improved across all groups. F2F and DGT+ showed comparable improvements. DGT performed worse but not significantly worse than F2F (P = 0.077). Average per-participant costs were US$209.26 for F2F, US$150.42 for DGT+ and US$121.24 for DGT. Cost-effectiveness analyses showed digital approaches were more cost-effective at lower willingness-to-pay thresholds. Findings suggest that digital training, especially when supported by coaching, offer scalable and lower-cost alternatives to classroom-based training for expanding workforce capacity to deliver depression care. Further research is needed to determine whether knowledge gains translate into clinical competency and effective care delivery. ClinicalTrials.gov Identifier: NCT04157816 . Frontline health workers in rural Madhya Pradesh, India, trained with digital training approaches to deliver behavioral activation intervention for depression achieved comparable improvements in knowledge, especially when supported by remote coaching, to health workers that were trained using face-to-face classroom-based training.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"4 8","pages":"1285-1296"},"PeriodicalIF":9.3,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148696740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The neuroimaging correlates of depression established across six large-scale population datasets","authors":"Kassandra Miyoko Hamilton, Xiaoke Luo, Ty Easley, Fyzeen Ahmad, Thomas Guo, Setthanan Jarukasemkit, Hailey Modi, Samuel Naranjo Rincón, Cabria Shelton, Lyn Stahl, Zijian Wang, Yuling Zhu, Petra Lenzini, Deanna M. Barch, Yvette I. Sheline, Kayla Hannon, Janine D. Bijsterbosch","doi":"10.1038/s44220-026-00680-y","DOIUrl":"10.1038/s44220-026-00680-y","url":null,"abstract":"Depression has been linked to reduced size of subcortical regions and abnormal functional connectivity in frontal and default mode networks. However, recent meta-analyses have failed to identify significant converging correlates of depression across the literature such that a conclusive mapping of the neuroimaging correlates of depression remains elusive. We leveraged 23,417 participants across 6 population datasets to comprehensively establish the neuroimaging correlates of depression. We found reductions in gray matter volume/cortical surface area associated with depression in the frontal cortex, anterior cingulate and insula, confirming previous studies showing the importance of prefrontal and default mode regions in depression. Our findings demonstrate multiple surprising results, including a lack of depression correlates in subcortical brain regions and significant depression correlates in somatomotor and visual regions. Overall, these results shed new light on key brain regions involved in the pathophysiology of depression, updating our understanding of the neuroimaging correlates of depression symptoms. In this study, the authors use 6 large-scale neuroimaging datasets (N = 23,417 participants) to systematically investigate structural and functional connectivity correlates of depression.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"4 8","pages":"1329-1341"},"PeriodicalIF":9.3,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major depressive disorder: advancing treatment; missing translation","authors":"","doi":"10.1038/s44220-026-00689-3","DOIUrl":"10.1038/s44220-026-00689-3","url":null,"abstract":"Research on major depressive disorder is delivering increasingly reliable biological and behavioral signals, from reward-processing deficits to brain signatures shared across populations. The challenge has shifted from discovery to delivery: translating these advances into tools that meaningfully improve care.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"4 7","pages":"1045-1046"},"PeriodicalIF":9.3,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s44220-026-00689-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148409634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probing biomarkers and clinical utility of reward learning across species using the Probabilistic Reward Task: 20 years of findings","authors":"Diego A. Pizzagalli","doi":"10.1038/s44220-026-00631-7","DOIUrl":"10.1038/s44220-026-00631-7","url":null,"abstract":"Disrupted reward processing, including reward learning, is a prominent feature of various neuropsychiatric disorders. Such abnormalities are particularly consequential in major depressive disorder in which anhedonia (reduced reactivity to pleasurable stimuli) predicts a host of negative outcomes, including poor response to treatments, worse disease course, impaired psychosocial functioning and suicide. Despite substantial research in this area, there are no approved treatments for anhedonia; reasons for such modest progress include the use of vastly disparate approaches to assess anhedonic behaviors in laboratory animals and humans (leading to poor translation) and overreliance on clinical scales in humans, which generally fail to parse important subdomains of reward processing. To address these and other gaps, in 2005 we published the first report evaluating the Probabilistic Reward Task in individuals with elevated depressive symptoms. Rooted in signal-detection theory, this task allows objective assessment of reward learning, that is, the propensity of an individual to modulate behavior as a function of reward. Critically, functionally identical PRT versions have been developed for mice, rats, nonhuman primates and humans, and data across species are analyzed using identical formulae and computational models. In this Review we summarize 20 years of PRT findings, organized according to several forms of validity—construct, clinical (diagnostic), prognostic, predictive, susceptibility/risk, biological and external validity. In addition, we summarize the PRT’s psychometrics and context of use. The rich body of findings across species, conditions and samples provides a foundation for future work that will contribute to the development of much-needed treatments targeting anhedonia. This Review addresses anhedonia in major depressive disorder, highlighting the Probabilistic Reward Task’s effectiveness across species for assessing reward learning. This work emphasize the task’s validity and psychometrics, offering insights for future treatment development targeting this challenging symptom.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"4 7","pages":"1066-1087"},"PeriodicalIF":9.3,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148409625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A precision medicine trial of bupropion and sertraline for major depressive disorder using a biomarker-guided sequential multiple-assignment design","authors":"Peter Zhukovsky, Manuel Kuhn, Lauren R. Borchers, Boyu Ren, Sarah E. Woronko, Mohan Li, Choi Sze Tracy Lam, Ethan M. Zhang, Kerry J. Ressler, Brian P. Brennan, Gordana Vitaliano, Diego A. Pizzagalli","doi":"10.1038/s44220-026-00671-z","DOIUrl":"10.1038/s44220-026-00671-z","url":null,"abstract":"Treatment for major depressive disorder (MDD) remains challenging as only 30–50% of patients respond to first-line antidepressant medications in primary care. Here we developed algorithms using predictors of response to sertraline and bupropion from a multisite study, and tested such markers in an independent, prospective clinical trial involving unmedicated individuals with MDD ( NCT05537584 ). Leave-one-out cross-validation models achieved good performance in the training sample (area under the curve of 0.66–0.86). In the preregistered clinical trial, no significant differences in treatment outcomes emerged for those assigned a drug consistent versus inconsistent with their biomarkers. However, significant differences emerged in symptom reduction trajectories for those with positive markers for both medications (response rate: 71.4%) or either drug (65.4%) compared with those with two negative markers (42.9%). This is the first study using biobehavioral markers to prospectively guide assignment to two widely used antidepressants, yielding a 66.8% boost in response rate and providing foundations for larger personalized treatment studies of MDD. In this precision trial, Zhukovsky et al. developed algorithms to predict sertraline or bupropion response, assigning independent, medication-free patients with major depressive disorder to one drug or the other on the basis of biobehavioral precision markers validated in a prospective trial.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"4 7","pages":"1099-1108"},"PeriodicalIF":9.3,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s44220-026-00671-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148409633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stability of childhood maltreatment self-reports: a systematic review and meta-analysis","authors":"Oonagh Coleman, Maya Al-Jaber, Geethma Aponsu, Daniel Stahl, Andrea Danese","doi":"10.1038/s44220-026-00677-7","DOIUrl":"10.1038/s44220-026-00677-7","url":null,"abstract":"Research and clinical practice on childhood maltreatment largely rely on retrospective self-reports. However, self-reports are often considered unreliable due to concerns about memory biases and shifting subjective appraisals. Here, in a meta-analysis of 49 studies including n = 38,332 individuals followed for an average of 2.4 years (range = 2 months to 12 years), we found that retrospective self-reports of maltreatment are overall highly stable (r = 0.79). However, stability was lower in population-representative samples than in clinical or convenience samples, for neglect compared with abuse, and in children compared with adults. In children, but not adults, stability declined with longer follow-up. These findings challenge the view that retrospective self-reports are inherently unstable, although further research is needed to investigate long-term stability. Reshaping trauma-related appraisals may require deliberate intervention and might be most effective during childhood when memories appear more malleable. In this meta-analysis of 49 studies, the authors find that self-reports of childhood maltreatment are generally stable, challenging assumptions of inherent unreliability and suggesting that traumatic memories may be more easily targeted by intervention during childhood.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"4 8","pages":"1315-1328"},"PeriodicalIF":9.3,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The promise of digital phenotyping for the early detection of risk for depression in adolescents","authors":"Eugenia Giampetruzzi, Chase Antonacci, Ian H. Gotlib","doi":"10.1038/s44220-026-00679-5","DOIUrl":"10.1038/s44220-026-00679-5","url":null,"abstract":"Advances in consumer wearables and machine learning enable the continuous detection of depression risk through behavioral and physiological data. In this Comment, we emphasize the crucial need to apply these technologies to adolescents, highlighting the potential for early detection and prevention of depression during this pivotal developmental stage.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"4 8","pages":"1193-1195"},"PeriodicalIF":9.3,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148696677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}